Objective To explore the influencing factors for the occurrence of eustachian tube dysfunction (ETD) in patients with nasopharyngeal carcinoma after radiotherapy, and to construct a prediction model. Methods A total of 172 patients with nasopharyngeal carcinoma were enrolled as study subjects. Based on whether ETD occurred after radiotherapy, they were divided into an ETD group (n=55) and a non-ETD group (n=117). Logistic regression and decision tree prediction models were then constructed, and the area under the receiver operating characteristic（ROC） curve was used to compare their predictive effectiveness for ETD in patients with nasopharyngeal carcinoma after radiotherapy. Results The results of Logistic regression analysis revealed that age, T stage, pre-radiotherapy serum albumin level, total neck radiation dose, and concurrent chemotherapy were influencing factors for post-radiotherapy ETD in patients with nasopharyngeal carcinoma (P<0.05). Meanwhile, the decision tree model identified total neck radiation dose, T stage, and concurrent chemotherapy as influencing factors for the occurrence of ETD in these patients after radiotherapy (P<0.05). The results of ROC curve analysis showed that no statistically significant difference was found in the predictive efficacy between the Logistic regression model and the decision tree model (P>0.05). Conclusion T stage, concurrent chemotherapy and total neck radiation dose are influencing factors for the development of ETD in patients with nasopharyngeal carcinoma after radiotherapy. Both the Logistic regression model and the decision tree model can effectively predict the risk of post-radiotherapy ETD in these patients , and these two models can be applied in combination clinically.

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